Effective 4/12/2023
| Procedure Code | Home Care | Fee |
|---|---|---|
| G0299 | Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, up to 2 hours | $210 |
| G0299 | Direct skilled nursing services of a registered nurse (RN) in the home health or hospice setting, each additional hour after the first 2 hours | $60 |
| G0300 | Direct skilled nursing services of a licensed practical nurse (LPN) in the home health or hospice setting, up to 2 hours | $151 |
| G0300 | Direct skilled nursing services of a licensed practical nurse (LPN) in the home health or hospice setting, each additional hour after the first 2 hours | $60 |
| S9110 | Telemonitoring of patient in their home, including all necessary equipment; computer system, connections, and software; maintenance; patient education and support; per month | $210 |
| G0151 | Services performed by a qualified physical therapist in the home health or hospice setting, each visit | $217 |
| G0157 | Services performed by a qualified physical therapist assistant in the home health or hospice setting, each visit | $130 |
| G0152 | Services performed by a qualified occupational therapist in the home health or hospice setting, each visit | $200 |
| G0153 | Services performed by a qualified speech-language pathologist in the home health or hospice setting, each visit | $310 |
| G0155 | Services of clinical social worker in home health or hospice settings, each visit | $190 |
| G0156 | Services of home health/hospice aide in home health or hospice settings, up to 2 hours | $105 |
| G0156 | Services of home health/hospice aide in home health or hospice settings, for each additional hour after the first 2 hours | $35 |
| G8780 | Counseling for diet and physical activity performed | $120 |
| Procedure Code | Hospice Care | Fee |
|---|---|---|
| Q5001 | Hospice or home health care provided in patient's home/residence (1-60 days) | $225 |
| Q5002 | Hospice or home health care provided in assisted living facility (1-60 days) | $225 |
| Q5003 | Hospice care provided in nursing long term care facility (LTC) or non-skilled nursing facility (1-60 days) | $225 |
| Q5001 | Hospice or home health care provided in patient's home/residence (61+ days) | $175 |
| Q5002 | Hospice or home health care provided in assisted living facility (61+ days) | $175 |
| Q5003 | Hospice care provided in nursing long term care facility (LTC) or non-skilled nursing facility (61+ days) | $175 |
| Q5001 | Continuous Hospice or home health care provided in patient's home/residence | $65 |
| Q5002 | Continuous Hospice or home health care provided in assisted living facility | $65 |
| Q5003 | Continuous Hospice care provided in nursing long term care facility (LTC) or non-skilled nursing facility | $65 |
| Q5009 | Continuous Hospice or home health care provided in place not otherwise specified | $65 |
| Q5010 | Continuous Hospice or home health care provided in hospice residential facility | $65 |
| Q5005 | Inpatient Respite Care in inpatient hospital | $495 |
| Q5006 | Inpatient Respite Care in inpatient hospice facility | $495 |
| Q5005 | General Inpatient Care in inpatient hospital | $1,115 |
| Q5006 | General Inpatient Care in inpatient hospice facility | $1,115 |